# WILLIAM J. VAN WYK M.D., P.A.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1073781050
- **Authorized official:** WILLIAM J. VAN WYK M.D., P.A. (PRESIDENT)
- **Authorized official phone:** (817) 877-3113

## Contact information

- **Practice address:** 803 W TERRELL AVE, FORT WORTH, TX 76104-3155
- **Practice address phone:** (817) 877-3113
- **Practice address fax:** (817) 877-0022
- **Mailing address:** 803 W TERRELL AVE, FORT WORTH, TX 76104-3155
- **Mailing address phone:** (817) 877-3113
- **Mailing address fax:** (817) 877-0022

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | D9696 | TX | Yes |

## Other

- **Enumeration date:** 02/13/2008
- **Last updated:** 02/16/2011